肺移植术中上腔静脉血与混合静脉血血氧饱和度的比较  

Comparison of oxygen saturation between the blood of superior vena cava and mixed venous in lung transplantation

作　　者：顾正峰[1] 杨建平[1] 王志萍[2] 辛莲[2] 高宏[2] 杨勇刚[2] 

机构地区：[1]苏州大学附属第一医院麻醉科,215006 [2]无锡市人民医院麻醉科,214023

出　　处：《实用医学杂志》2014年第24期3989-3991,共3页The Journal of Practical Medicine

摘　　要：目的：在肺移植术中,比较上腔静脉血与混合静脉血血氧饱和度,为麻醉中选择监测方法提供参考。方法：接受肺移植手术的患者30例,分别置入中心静脉导管于上腔静脉、漂浮导管于肺动脉。在置管后（T1）、第一侧病肺切除前（T2）、第一侧供肺开放后（T3）、第二侧病肺切除前（T4）、第二侧供肺开放后（T5）以及手术结束前（T6）同时抽取上腔静脉血和肺动脉血行血气分析。比较上腔静脉血与混合静脉血血气分析中血氧饱和度。结果：T1~T6,上腔静脉血Sp O2与混合静脉血Sp O2Bland-Altman一致性检验：均数差值依次为0.9、3.4、2.3、0.5、0.27和-2.9,超上下限范围发生率为3.3%、0%、0%、3.3%、3.3%和0%,位于Bland-Altman一致性界限内的百分率为96.7%、100%、100%、96.7%、96.7%和100%。结论：在肺移植手术过程中,上腔静脉血Sp O2可以作为混合静脉血Sp O2的近似参考。Objective To compare the oxygen saturation between the blood of superior vena cava and mixed venous in lung transplantation and provide reference for monitoring method in anesthesia. Methods 30 patien ：s who received lung transplantation were placed central venous catheter into superior vena cava and flotation catheter into the pulmonary artery in turn. The blood samples were collected from the superior vena eava and pulmonary artery for blood gas analysis simultaneously at the time of just followed the catheter placement （T1）, before the resection of the first bad lung （T2）, after the reperfusion of the first donor lung （T3）, before the resection of the second bat lung （T4）, after the reperfusion of the second donor lung （T5）, before the end of the operation （T6）. The oxygen satl ration were compared between the blood of the superior vena cava and mixed venous. Results From T1 to T6, Bland-/,ltman analysis showed that the mean of deviation between the SpO2 measured in blood of superior vena cava and mixed venous were 0.5, 3.4, 2.3, 0.5, 0.27, -2.9, respectively, and the incidence beyond the upper and lowed liJnits of consistency zone was 3.3%, 0%, 0%, 3.3%, 3.3%, 0% respectively. The incidence of SpO2 within the consistent limits was 96.7%, 100%, 100%, 96.7%, 96.7%, 100% respectively. Conclusions The SpO2 of superior vena cava may be approximately reference as SpO2 of mixed venous during lung transplantation.

关 键 词：上腔静脉血 混合静脉血 血氧饱和度 肺移植 

分 类 号：R614[医药卫生—麻醉学]